﻿@{
    ViewBag.Title = "ceacesmr";
}
<!DOCTYPE html>
<html>
<head>
    <meta name="viewport" content="width=device-width" />
    <title>CEA、CAS 病历</title>
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    <style>
      body{overflow-x:auto;margin:5px;min-width:900px;}
	.radio_label{display:inline-block;width:auto;height:22px;background:url(/content/images/radiobutton.png) no-repeat;background-position:-13px -16px;text-indent:22px;line-height:22px;}
	.radio_label:hover{background-position:-13px -116px;}
	input[type=radio]{width:0;}
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	.checked{background-position:-13px -216px;}
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	input[type=checkbox]{width:0;}
    </style>
</head>
<body>
    <form method="post" id="formSubmit">
        <div class="l-loading" style="display: none;" id="pageloading">
        </div>
        <div class="topPosition">
            <div style="float:left;font-size:13px;">
                <div style="float:left; margin-left:20px;">
                    手术类型：CEA、CAS
                </div>
            </div>
            <div style="float:right;margin-right:10px;">
                <input type="hidden" id="txtPIId" value="" />
                <input type="hidden" id="txtAIId" value="" />
                <input type="hidden" id="txtPCId" value="" />
                <input type="hidden" id="txtPSId" value="" />
                <input type="hidden" id="txtPatientId" value="@ViewBag.patientId" />
                <input id="btnHisback" type="button" value="返回" class="l-button" style="height:26px;" />
                <input id="btnTimeLine" type="button" value="时间轴" class="l-button" style="height:26px;" />
                <input id="btnTimePath" type="button" value="时间路径" class="l-button" style="height:26px;" />
                <input id="btnPrint" type="button" value="打印" class="l-button" style="height:26px;" />
                <input id="btnDel" type="button" value="删除" class="l-button" style="height:26px;" />
                <input id="btnSave" type="button" value="保存" class="l-button" style="height:26px;" />
                <input id="btnReview" type="button" value="审核" class="l-button" style="height:26px;display:none;" />
            </div>
        </div>
        <div style="height:100%;">
            <div class="lift-nav">
                <ul class="lift">
                    <li>基本信息</li>
                    <li>入院评估</li>
                    <li>体格检查</li>
                    <li>CEA/CES手术</li>
                    <li>术后药物治疗</li>
                    <li>健康教育</li>
                    <li>出院情况</li>
                </ul>
            </div>
            <div class="lift-target">
                <div class="t0" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>基本信息</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">姓名：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtrealName" name="txtrealName" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    性别：
                                    <label><input class="l-radio" type="radio" id="rdogender1" name="rdogender" value="1" />男</label>
                                    <label><input class="l-radio" type="radio" id="rdogender0" name="rdogender" value="0" />女</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    民族： <input type="text" id="txtethnic" name="txtethnic" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">

                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">身份证：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtIDcard" name="txtIDcard" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    住院号： <input type="text" id="txtlivePid" name="txtlivePid" class="l-text" />
                                </div>
                                <div style="float: left; height: 35px; line-height: 35px; margin-left: 27px;">
                                    住院时间： <input type="text" id="txtlivePtime" name="txtlivePtime" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">病人编号：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtpatId" name="txtpatId" class="l-text" readonly="readonly" />
                                </div> <div style="float:left;height:35px;line-height:35px;margin-left:27px;display:none;">
                                    病案号： <input type="text" id="txtpataId" name="txtpataId" class="l-text" readonly="readonly" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">医疗付款方式：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance0" name="chkmedicalinsurance" value="0" />城镇职工基本医疗保险</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance1" name="chkmedicalinsurance" value="1" />城镇居民基本医疗保险</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance2" name="chkmedicalinsurance" value="2" />新型农村合作医疗</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance3" name="chkmedicalinsurance" value="3" />贫困救助</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">&nbsp;</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance4" name="chkmedicalinsurance" value="4" />商业医疗保险</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance5" name="chkmedicalinsurance" value="5" />全公费</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance6" name="chkmedicalinsurance" value="6" />全自费</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance7" name="chkmedicalinsurance" value="7" />其他社会保险</label>
                                    <label><input type="radio" class="l-radio" id="chkmedicalinsurance8" name="chkmedicalinsurance" value="8" />其他</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">住院次数：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtlivePcount" name="txtlivePcount" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    来院方式：
                                    <label><input class="l-radio" type="radio" name="comeType" id="comeType0" value="0" />本院急救车</label>
                                    <label><input class="l-radio" type="radio" name="comeType" id="comeType1" value="1" />当地120</label>
                                    <label><input class="l-radio" type="radio" name="comeType" id="comeType2" value="2" />外院转院</label>
                                    <label><input class="l-radio" type="radio" name="comeType" id="comeType3" value="3" />自行来院</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">入院途径：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input class="l-radio" type="radio" name="rdocomeinType" id="rdocomeinType0" value="0" />急诊</label>
                                    <label><input class="l-radio" type="radio" name="rdocomeinType" id="rdocomeinType1" value="1" />门诊</label>
                                    <label><input class="l-radio" type="radio" name="rdocomeinType" id="rdocomeinType2" value="2" />其他医疗机构转入</label>
                                    <label><input class="l-radio" type="radio" name="rdocomeinType" id="rdocomeinType3" value="3" />其他</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>

                <div class="t1" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>入院评估</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">入院mRS评分：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label> <input class="l-radio" type="radio" name="rdocomeinismRs" id="rdocomeinismRs1" value="1" />已评</label>
                                    <label> <input class="l-radio" type="radio" name="rdocomeinismRs" id="rdocomeinismRs0" value="0" />未评</label>
                                </div>
                                <div id="rdocomeinismRsYes" style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    评分分数： <input type="text" id="txtcomeinmRs" name="txtcomeinmRs" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">入院NIHSS评分：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label> <input class="l-radio" type="radio" name="rdocomeinisNihss" id="rdocomeinisNihss1" value="1" />已评</label>
                                    <label> <input class="l-radio" type="radio" name="rdocomeinisNihss" id="rdocomeinisNihss0" value="0" />未评</label>
                                </div>
                                <div id="rdocomeinisNihssYes" style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    评分分数： <input type="text" id="txtcomeinNihss" name="txtcomeinNihss" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">吞咽功能评估：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdotygnpgischk" id="rdotygnpgischk1" value="1" />已评</label>
                                    <label><input type="radio" class="l-radio" name="rdotygnpgischk" id="rdotygnpgischk0" value="0" />未评</label>
                                </div>
                                <div id="txtwtyssyValYes" style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    洼田饮水实验： <input type="text" id="txtwtyssyVal" name="txtwtyssyVal" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">是否有症状：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoishaveill" id="rdoishaveill1" value="1" />有</label>
                                    <label><input type="radio" class="l-radio" name="rdoishaveill" id="rdoishaveill0" value="0" />无</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    颈部血管检查：
                                    <label><input type="checkbox" class="l-checkbox" name="cbxjbxgcschk" id="cbxjbxgcschk0" value="0" />颈部血管超声</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxjbxgcschk" id="cbxjbxgcschk1" value="1" />CTA</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxjbxgcschk" id="cbxjbxgcschk2" value="2" />MRA</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxjbxgcschk" id="cbxjbxgcschk3" value="3" />DSA</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxjbxgcschk" id="cbxjbxgcschk4" value="4" />未查</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;"> 结果/是否有狭窄：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoreshavexz" id="rdoreshavexz1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoreshavexz" id="rdoreshavexz0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;"><span id="rdoreshavexzYes3">狭窄部位：</span></td>
                            <td>
                                <div id="rdoreshavexzYes1" style="float:left;height:35px;line-height:35px;">
                                    左侧：
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal0" value="0" />颈总</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal1" value="1" />球部</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal2" value="2" />颈内</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal3" value="3" />锁骨下动脉</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal4" value="4" />椎动脉</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyareal" id="rdohavexzbodyareal5" value="5" />无</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">&nbsp;</td>
                            <td>
                                <div id="rdoreshavexzYes2" style="float:left;height:35px;line-height:35px;">
                                    右侧：
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear0" value="0" />颈总</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear1" value="1" />球部</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear2" value="2" />颈内</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear3" value="3" />锁骨下动脉</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear4" value="4" />椎动脉</label>
                                    <label><input type="radio" class="l-radio" name="rdohavexzbodyarear" id="rdohavexzbodyarear5" value="5" />无</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>

                <div class="t2" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>体格检查</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">身高(cm)：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtpheigh" name="txtpheigh" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    体重(kg)： <input type="text" id="txtpweight" name="txtpweight" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    BMI(kg/㎡)： <input type="text" id="txtbmiVal" name="txtbmiVal" class="l-text" readonly="readonly" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">收缩压(mmHg)：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtpssyVal" name="txtpssyVal" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    舒张压(mmHg)： <input type="text" id="txtpszyVal" name="txtpszyVal" class="l-text" />
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    脉搏(次/分)： <input type="text" id="txtpmbVal" name="txtpmbVal" class="l-text" />
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>

                <div class="t3" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>CEA/CES手术</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">是否有症状：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoishaveillinExc" id="rdoishaveillinExc1" value="1" />有</label>
                                    <label><input type="radio" class="l-radio" name="rdoishaveillinExc" id="rdoishaveillinExc0" value="0" />无</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    手术开始时间： <input type="text" id="txtexcStartTime" name="txtexcStartTime" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">手术部位：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexcBodyPostion" id="cbxexcBodyPostion0" value="0" />LIA</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexcBodyPostion" id="cbxexcBodyPostion1" value="1" />RICA</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    麻醉方式：
                                    <label><input type="radio" class="l-radio" name="rdoexcpmzType" id="rdoexcpmzType0" value="0" />全麻</label>
                                    <label><input type="radio" class="l-radio" name="rdoexcpmzType" id="rdoexcpmzType1" value="1" />局麻</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">实施监测手段：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexcssjcType" id="cbxexcssjcType0" value="0" />TCD</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexcssjcType" id="cbxexcssjcType1" value="1" />脑电图</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexcssjcType" id="cbxexcssjcType2" value="2" />其他</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;">
                                    手术采取方式：
                                    <label><input type="radio" class="l-radio" name="rdoexcGetType" id="rdoexcGetType1" value="0" />外翻式CEA</label>
                                    <label><input type="radio" class="l-radio" name="rdoexcGetType" id="rdoexcGetType0" value="1" />标准式CEA</label>
                                    <label><input type="radio" class="l-radio" name="rdoexcGetType" id="rdoexcGetType3" value="2" />CAS</label>
                                    <label><input type="radio" class="l-radio" name="rdoexcGetType" id="rdoexcGetType4" value="3" />复合手术</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">是否采用补片：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoexcisUsebps" id="rdoexcisUsebps1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoexcisUsebps" id="rdoexcisUsebps0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">并发症：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs0" value="0" />脑梗死</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs1" value="1" />高灌注</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs2" value="2" />脑出血</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs3" value="3" />周围神经损伤</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs4" value="4" />切口感染</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs5" value="5" />继发性癫痫</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs6" value="6" />肺部感染</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs7" value="7" />泌尿系感染</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs8" value="8" />其他</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexchavebfzs" id="cbxexchavebfzs9" value="9" />无</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>


                <div class="t4" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>术后药物治疗</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">抗血小板药物：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoshiskxxbyw" id="rdoshiskxxbyw1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoshiskxxbyw" id="rdoshiskxxbyw0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">抗凝药物：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoshisknyw" id="rdoshisknyw1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoshisknyw" id="rdoshisknyw0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">降压药物：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoshisjyyw" id="rdoshisjyyw1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoshisjyyw" id="rdoshisjyyw0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">调脂药物：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoshistzyw" id="rdoshistzyw1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoshistzyw" id="rdoshistzyw0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;"><span id="rdoshistzywYes2">调脂药物种类：</span></td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;" id="rdoshistzywYes1">
                                    <label><input type="checkbox" class="l-checkbox" name="cbxshtzywType" id="cbxshtzywType0" value="0" />他汀类</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxshtzywType" id="cbxshtzywType1" value="1" />盐酸及其衍生物</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxshtzywType" id="cbxshtzywType2" value="2" />贝特类</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxshtzywType" id="cbxshtzywType3" value="3" />胆固醇吸收抑制器</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxshtzywType" id="cbxshtzywType4" value="4" />其他</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">降糖药物：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoshisjtyw" id="rdoshisjtyw1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoshisjtyw" id="rdoshisjtyw0" value="0" />否</label>
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;"><span id="rdoshisjtywYes1">降糖药物种类：</span></td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;" id="rdoshisjtywYes2">
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType0" value="0" />胰岛素</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType1" value="1" />磺酰脲类</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType2" value="2" />双胍类</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType3" value="3" />a糖苷酶抑制剂</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType4" value="4" />胰岛素增敏剂</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType5" value="5" />非磺酰脲类促胰岛分泌剂</label>
                                    <label><input type="checkbox" class="l-checkbox" name="chxshjtywType" id="chxshjtywType6" value="6" />其他</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>

                <div class="t5" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>健康教育</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">健康宣教：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoheathisxj" id="rdoheathisxj1" value="1" />是</label>
                                    <label><input type="radio" class="l-radio" name="rdoheathisxj" id="rdoheathisxj0" value="0" />否</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;" id="rdoheathisxjYes">
                                    宣教方式：
                                    <label><input type="checkbox" class="l-checkbox" name="cbxheathxjType" id="cbxheathxjType0" value="0" />集体病区教育</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxheathxjType" id="cbxheathxjType1" value="1" />一对一教育</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxheathxjType" id="cbxheathxjType2" value="2" />其他</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>
                <div class="t6" style="margin-top:55px;">
                    <table style="width: 100%;">
                        <tr style="height: 35px;">
                            <td colspan="2" style="text-align: center;">
                                <h3>出院情况</h3>
                                <hr />
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">出院时间：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <input type="text" id="txtexitPtime" name="txtexitPtime" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">离院方式：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType0" value="0" />医嘱离院</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType1" value="1" />医嘱转院</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType2" value="2" />医嘱转社区服务机构/乡镇卫生院</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType3" value="3" />非医嘱离院</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType4" value="4" />死亡</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitPType" id="ExitPType5" value="5" />其他</label>
                                </div>
                            </td>
                        </tr>

                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">出院mRS评分：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoexitismRs" id="rdoexitismRs1" value="1" />已评</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitismRs" id="rdoexitismRs0" value="0" />未评</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;" id="rdoexitismRsYes">
                                    评分：<input type="text" id="txtexitmRsVal" name="txtexitmRsVal" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;"> 出院NIHSS评分：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="radio" class="l-radio" name="rdoexitisHihss" id="rdoexitisHihss1" value="1" />已评</label>
                                    <label><input type="radio" class="l-radio" name="rdoexitisHihss" id="rdoexitisHihss0" value="0" />未评</label>
                                </div>
                                <div style="float:left;height:35px;line-height:35px;margin-left:27px;" id="rdoexitisHihssYes">
                                    评分：<input type="text" id="txtexitHihssVal" name="txtexitHihssVal" class="l-text" />
                                </div>
                            </td>
                        </tr>
                        <tr style="height: 35px;">
                            <td style="width:120px; text-align: right;">出院带药：</td>
                            <td>
                                <div style="float:left;height:35px;line-height:35px;">
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy0" value="0" />降压药</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy1" value="1" />降糖药</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy2" value="2" />调脂药</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy3" value="3" />抗凝药</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy4" value="4" />抗血小板药</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy5" value="5" />中药治疗</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy6" value="6" />其他</label>
                                    <label><input type="checkbox" class="l-checkbox" name="cbxexitpwithy" id="cbxexitpwithy7" value="7" />无</label>
                                </div>
                            </td>
                        </tr>
                    </table>
                </div>
            </div>
        </div>
    </form>
</body>
</html>
